Rescuing the bottom billion through control of neglected tropical diseases

Here, low-cost opportunities to control the neglected tropical diseases through preventive chemotherapy are outlined, and financial innovations to provide poor individuals with essential drugs are proposed.

Abstract

People in the bottom billion are the poorest in the world; they are often subsistence farmers, who essentially live on no money and are stuck in a poverty trap of disease, conflict, and no education. 1 Collier P The bottom billion: why the poorest countries are failing and what can be done about it. Oxford University Press, Oxford2007: 3-13 Google Scholar , 2 Sachs JD Common wealth: economics for a crowded planet. The Penguin Press, New York2008: 386 Google Scholar One of the most potent reinforcements of the poverty trap is the neglected tropical diseases (panel 1). 3 Hotez PJ Molyneux DH Fenwick A et al. Control of neglected tropical diseases. N Engl J Med. 2007; 357: 1018-1027 Crossref PubMed Scopus (1116) Google Scholar Almost everyone in the bottom billion has at least one of these diseases. Several diseases coexist in 56 of 58 countries that are home to the people in the bottom billion. 3 Hotez PJ Molyneux DH Fenwick A et al. Control of neglected tropical diseases. N Engl J Med. 2007; 357: 1018-1027 Crossref PubMed Scopus (1116) Google Scholar Here we outline low-cost opportunities to control the neglected tropical diseases through preventive chemotherapy, and propose financial innovations to provide poor individuals with essential drugs. Panel 1Poverty-promoting features of neglected tropical diseasesReduced child survival Hookworm infection; ascariasis; trichuriasis; schistosomiasis Costs of treatments and seeking inappropriate or ineffective health care Leishmaniasis; lymphatic filariasis; onchocerciasis; human African trypanosomiasis Reduced agricultural productivity Lymphatic filariasis; onchocerciasis; trachoma; hookworm infection; schistosomiasis; dracunculiasis Educational effects Hookworm infection; trichuriasis; ascariasis; schistosomiasis; onchocerciasis Reduced child survival Hookworm infection; ascariasis; trichuriasis; schistosomiasis Costs of treatments and seeking inappropriate or ineffective health care Leishmaniasis; lymphatic filariasis; onchocerciasis; human African trypanosomiasis Reduced agricultural productivity Lymphatic filariasis; onchocerciasis; trachoma; hookworm infection; schistosomiasis; dracunculiasis Educational effects Hookworm infection; trichuriasis; ascariasis; schistosomiasis; onchocerciasis